Dr. Ted Mazer is one of the few ear, nose and throat specialists in this region who treat low-income people on Medicaid, so many of his patients travel long distances to see him. But now, as California's Medicaid program is preparing for a major expansion under President Obama's health care law, Dr. Mazer says he cannot accept additional patients under the government insurance program for a simple reason: It does not pay enough. "It's a bad situation that is likely to be made worse," he said.